Depression Flashcards
Labs for depression
CBC, TSH, HIV/STD, VitB12/folate
Normal score on Geriatric Depression Scale
0-5
Depression Scale available in several languages
Geriatric Depression Scale
Preliminary scored based on informant; then final score based on clinician impression after interviewing the patient
Cornell Depression in Dementia Scale
Common antidepressant
Mitazepine (Remron?)
High effort, low insight
Dementia
Low effort, apathetic
Depressed
Barrier to Tx that may be overlooked
ETOH abuse
Why do clinicians miss depression?
Prejudice
Depression without sadness can show as
anxiety, irritability, etc, poor appetite
Does major depression increase with age?
No, unless medically ill or institutionalized
Cognitive Behavior Therapy works well with?
Antidepressants
Do depression meds work immediately?
No, must give it 3-6 weeks
Which therapy approach works well?
Problem solving therapy, reminiscence therapy, grief and group therapy.
Extremely common in neurocognitive disorders
Apathy
*dementia
Choose psychostimulants based on what pharmacologic characterisitc?
short half-life
Psychostimulant with 1 hr onset, 2-4 hour half life and low dependence
Methylphenidate
My increase levels of Coumadin, TCA antidepressants, and anticonvulsants
Methylphenidate
Tx goal for apathy?
Boost activity level
Apathy + Ahedonia are considered part of
depression
Antidepressants for apathy and depression
SSRI’s, Buproprion
Psychostimulants for apathy
Methylphenidate; Destroamphematine, Modafinil; Armodafinil
Dopaminergic agents for apathy
Bromocriptine, Amantadine, Pergolide
Cognitive enhancers for apathy
AChEIs/memantine
Nootropic agents for apathy
Nefiracetam
